Florida does not violate the Medicare Act by asserting a lien for 37.5% of a Medicare recipient’s settlement of his claim against a third party tortfeasor for injuries treated with Medicare benefits. Under Florida law, there is a presumption that 37.5% of any personal injury settlement is paid for past and future medical expenses unless rebutted by clear and convincing contrary evidence. Neither that presumption nor Florida’s recovery of that percentage of the settlement in compensation for Medicare benefits paid the recipient plaintiff is contrary to the Medicare Act’s provisions.